Facilitating a group

Group-based approaches to pain management are common. They’re used not just for cost-effectiveness (because there are some ‘hidden’ costs to groupwork such as screening participants and team meetings), but also because some processes are better conducted in a group setting – such as observing others ‘well’ behaviours, learning vicariously from others’ experiences – and because experiential learning in a group setting replicates many of the work and family settings that people who experience pain will need to function in.

I use experiential learning, that is, the idea that change and growth take place when people are actively (physically, socially, intellectually, emotionally) involved in their learning rather than just being receivers of inforamtion. It’s not new – cognitive behavioural therapy has used this philosophy since its inception, occupational therapy is based on the idea that doing invokes being. I’ve no doubt many other health professionals also consider that active involvement in processing and learning is essential to integrating new behaviours. To carry out experiential learning, facilitation skills are vital, but again not training that health professions often seriously study during undergraduate study.

Today’s book is one of several I’ve recently obtained to refresh my facilitation skills. I’ve been lucky enough to complete a five-day training several years ago on facilitation run by Zenergy. Zenergy have a distinct philosophy about the value of teamwork, the synergy that occurs when people align to a common purpose and that cooperacy will achieve much for the whole world. For a list of their training courses, go here. Some of us, however, can’t take the time to go to formal training, or want a reference book, so I was pleased to find this book at Amazon.

Now, there is a saying ‘don’t choose a book by its cover’ and I would add ‘don’t choose a book by its title’ because the title is‘The Secrets of Facilitation’, and that just smacked to me of cheesy pop psychology – but, perhaps surprisingly, this book has some very useable, practical ways for facilitators to ‘ask questions that ignite a bonfire of responses’, ‘discover the three reasons people disagree’, ‘resolve dysfunctional behaviour in four steps’ and ‘build consensus in meetings with five strategies’…

The Secrets of Facilitation: The S.M.A.R.T. guide to getting results with groups, written by Michael Wilkinson, published by Jossey-Bass, A Wiley Imprint: San Francisco, 2004. The book provides a model of group facilitation that incorporates both the flow of a facilitated session (preparing, starting a session, focusing the group, writing down resolutions, gathering information and finally closing the session – and includes asking questions to generate effective responses throughout the process); as well as the processes involved in group dynamics (how to manage dysfunction, build consensus, keep energy levels appropriate and set the agenda).

The book is not written for pain management, indeed it’s not written for health at all – it’s a business book aimed at helping teams function effectively so that group decisions are achieved and implemented (not that health teams EVER need to work on this, do they?). Despite this, so much of the book translates directly into both team functioning and group therapy sessions that I think it’s worth thinking about for your bookshelf.
What I like about the book is the straightforward language, the summaries at the end of each chapter, and the loads of example phrases and questions that you can immediately transfer into a clinical setting. Like many books, it includes some great tables that summarise the information – for example, a comparison of facilitator vs nonfacilitator responses listing what you might perceive (eg you don’t think what was said was correct), an example of both types of response, then a classification of the type of response that is recommended (eg Direct probe, indirect probe, leading question and so on). The diagrams have immediate appeal for me (I’m pretty visual!), and also help to give an overview of the construction of the book so you can see where each piece of the information given fits in.

What I liked less about the book is the example scenarios that relate to business or school settings, and so are not quite as easily transferred into the health setting – even though health can be considered a complex business enterprise! I also really dislike the ‘secrets’ concept. The book lists 60 so-called ‘secrets’, many of which are not exactly secret. I mean, do you think using energy-generating techniques throughout the session is a ‘secret to maintaining energy’?

Despite this somewhat tedious concept of ‘secrets’ the actual suggested strategies are effective. From the first chapter I picked up things I could use when facilitating group sessions on the pain management programme. Some good examples? Well, if someone comes up with an idea that you’re not sure about, acknowledge the contribution then ask them ‘how do you get around [X]’ and state what your concern is. He calls it ‘Building a PAC’ or listen, playback (reflect), agree (acknowledge the part/s that you can see merit in), then challenge or state your objection in the form of a question that allows the person to either solve your objection or to agree with it.
Another example is in using the whiteboard to record what participants say. The ‘secret’ is to write first (in other words, write down exactly the words the person says) then discuss what they’ve said. This ensures you as facilitator don’t imply that you know better than the participants, elicits more responses from participants who may otherwise begin to depend on you as facilitator for ‘the answers’.

If you want to help your team work together more effectively, or have a group of patients you’d like to help facilitate to achieve their goals – this book might just be what you’re looking for.